Short-term results of inflatable mediastinoscopy combined with laparoscopy versus robot-assisted-minimally invasive esophagectomy for esophageal cancer
Objective To investigate the safety,effectiveness and the short-term results between inlatable video-assisted mediastinoscopic transhiatal esophagectomy(IVMTE)and robot-assisted-minimally invasive esophagectomy(RAMIE)in the treatment of esophageal cancer.Methods Clinical data of 159 patients with esophageal cancer who underwent minimally invasive esophagectomy were enrolled in our hospital from October 2020 to July 2024.Patients were divided into two groups according to different surgi-cal methods,including RAMIE group(n=77)and IVMTE group(n=82).The general characteristics(include age,sex,tumor location,clinical stages)and perioperative clinical data(include the amount of bleeding,length of surgery,the rate of R0 resection,the number of lymph node,the number of left/right recurrent laryngeal nerve lymph node,the rate of postoperative complications,the score of VAS On the postoperative day 1,the postoperative length of stay)of the two groups were compared.Measurement data were analyzed using Student's t-test and counting data using chi-square test.Results There was no signif-icant difference between the two groups in the age,sex,tumor location,clinical stages and other general characteristics(t=0.731,x2=0.635,0.187,4.196,P＞0.05).There was no significant difference between the IVMTE group and RAMIE group in the amount of bleeding[(187±242)ml vs.(210±234)ml],the rate of R0 resection(97.6％vs.96.1％),the number of lymph node[(28.35±11.35)cells vs.(28.32±11.79)cells],the number of left/right recurrent laryngeal nerve lymph node[(3.00±2.99)cells vs.(2.71±2.48)cells,(2.88±2.57)cells vs.(3.34±2.94)cells],the rate of anastomotic fistula(2.4％vs.2.6％,t=0.594,x2=0.277,t=-0.016,t=-0.655,t=1.052,x2=0.004,P＞0.05).compared with the RAMIE group,the operation time[(311.3±75.3)min vs.(351.7±73.1)min],the rate of postoperative pulmonary infection(3.7％vs.13.0％),the score of VAS On the postoperative day 1[(4.2±1.3)points vs.(5.2±1.4)points],the postoperative length of stay[(9.2±3.2)day vs.(11.5±6.9)day]was significantly lower in the IVMTE group(t=3.430,x2=4.603,t=4.726,t=2.640,P＜0.05).RAMIE group harvested more number of thoracic lymph node than IVMTE group[(18.7±9.9)cells vs.(15.8±8.0)cells,t=2.027,P＜0.05].The 1-month survival rates was 100％in both group.Conclusion RAMIE and IVMTE was safe and feasible in the treatment of esophageal cancer.RAMIE could harvested more number of thoracic lymph node.IVMTE was less invasive,with shorter surgical time,the rate of postoperative pulmonary infection and the postoperative length of stay.Good short-term clinical prognosis was observed in both group.
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